High Prevalence of Musculoskeletal Disorders and Self-Medication among Street Vendors in Bangui, Central African Republic (CAR)

Introduction: Musculoskeletal disorders (MSDs) are a set of peri-articular conditions that result mainly in pain and functional discomfort. They represent a major occupational health problem in all areas of activity. The objective of this work was to determine the prevalence of MSDs among street vendors in the city of Bangui in the Central African Republic (CAR). Methods: A cross-sectional study was conducted from September 01 to October 31, 2021 in Bangui, the capital of CAR. The study population consisted of street vendors which were included at the entrance of 4 large markets of Bangui after giving informed consent. The sample size, calculated according to the Schwartz formula, was 384. Sociodemographic data (age, gender, level of education, marital status), professional data (the duration of sale in hours, the distance traveled per day);and health data (the health problems suffered by itinerant sellers and the means of dealing with them) were collected using a pre-established self-questionnaire. This collected data was processed using Microsoft Excel 2013 and Epi-Info version 7 software. Results: Among 384 street vendors included, women represented a quarter (24.9%). The average age was 27 years;the 25-34 age group was the most represented (50%). About two-thirds (64.8%) sold for at least 12 hours and traveled more than 10 km (69.3%) per day. The main health problems reported by street vendors were musculoskeletal disorders (95.8%). Their locations concerned the upper limbs shoulder 65.36% (251), elbow 24.22% (93). Non-ergonomic postures that stress the back and joints all day long, causing pain are risk factors for MSDs. These MSDs were treated by self-medication with non-steroidal anti-inflammatory drugs (22.0%), mainly sold on the street. Conclusion: MSDs dominated the health problems of street vendors. These problems raise the need for recognition and support for these workers to optimize their performance while preserving their health through awareness and good management of MSDs whose chronicity generates a disability.

Self-Medication during Eye Affections among Consultant Patients at Chu-Iota

Introduction: According to the World Health Organization (WHO), self-medication consists in the fact that an individual resorts to a drug, on his own initiative or that of a loved one, with the aim of treating an ailment or a symptom that he identified himself without having recourse to a health professional. Self-medication involves the use of medicinal products by the consumer to treat self-recognized disorders or symptoms, or the intermittent or continued use of a medication prescribed by a physician for chronic or recurring diseases or symptoms. The aim of this study is to determine the different characteristics of ophthalmic self-medication at the CHU-IOTA. Patients and Method: We conducted a prospective study in patients of any age who resorted to ophthalmological self-medication before the first consultation or during the ophthalmological care of consulting patients at the CHU-IOTA between January 1 and July 31, 2021. Results: Over the period, 521 cases of ophthalmological self-medication were collected out of a total of 24,512 consultations, which corresponds to a frequency of 2.12%. The average age was 37.7 years, [2 months - 78]. The sex ratio was 0.50. Economic factors were the main factor mentioned, 66.79%. Corticosteroids accounted for 45.26% of the pharmacological class with dexamethasone/neomycin eye drops being the most widely used, i.e. 22.94%. The most common complication was corticosteroid-induced ocular hypertension on ametropia, i.e. 15.54%. Our patients were 68.13% educated. Among his educated patients 53.35% had no knowledge of the products. Conclusion: Given the harm associated with this practice, awareness and information campaigns aimed at the population, caregivers and pharmacists or pharmacy vendors are necessary in order to reduce the frequency of the practice of self-medication.

Substance use and self-medication during pregnancy and associations with sociodemographic data:A cross-sectional survey

Objective:To identify women vulnerable to substance use and self-medication during pregnancy based on associations with socio-demographic data.Methods:Data were collected in person,with self-developed questionnaires,from pregnant women(n=422)in Chengdu,China,from July to November 2012.Multivariate logistic regression analysis was used to reveal associations with socio-demographic parameters.Results:Higher educational background,being employed,and higher educational background of the mother were associated with a 37%[odds ratio(OR):0.63,95%CI:0.45-0.89],65%(OR:0.35,95%CI:0.13-0.94),and 29%(OR:0.71,95%CI:0.53-0.96)less likelihood of alcohol use,respectively.Adverse pregnancy outcome was associated with a 2.13-fold(OR:2.13,95%CI:1.07-4.25)greater likelihood of alcohol use.Young age and higher educational background were associated with an 11%(OR:0.89,95%CI:0.81-0.98)and 31%(OR:0.69,95%CI:0.49-0.98)less likelihood of cigarette smoking,respectively.Conclusion:Socio-demographic parameters were associated with substance use during pregnancy and warrants targeted health education provided by nurses to pregnant women.

Self-Medication among Adults in Minia, Egypt: A Cross Sectional Community-Based Study

Self-medication may be associated with side effects and increases the chance of drug interactions and also affects the adherence to treatment and quality of life. This study aims at determining the pattern of self-medication, identifying knowledge, attitude and self-reported practices concerning the usage of the drugs and identifying demographic factors that could influence self-medication practices among the general population in El-Minia, Egypt. A community-based cross-sectional study was conducted among 422 randomly selected adults using a multi-stage random sampling technique. Data were collected by using a structured interview questionnaire. Respondents who had practiced some sort of self-medication during the past month were 73% of the sample. The commonest cause of self-medication, illness, was perceived as minor (59.7%). The most common perceived illness for self-medication was common cold (90.6%). Older respondents (>40 years) were about twice more likely to practice self-medication than younger ones. Similarly, professionals in their work were 3.4 times more likely to practice self-medication than unemployed individuals. Self-medication is a relatively frequent problem in Minia and interventions at different levels are required.

Self-Medication Practice against Malaria and Associated Factors in the City of Parakou in Northern Benin: Results of a Population Survey in 2017

Introduction: Self-medication is a common practice in Benin. It has many consequences on people’s health in general and develops chemoresistance in particular. Aim: The aim of this work is to study the practice of anti-malarial self-medication in the city of Parakou and to identify the associated factors with this practice. Methods: This was a descriptive cross-sectional analytical survey that took place in the period from April 15 to June 24, 2017. Adults who reported having had malaria symptoms in the last 6 months before the survey and living in 9 neighbourhoods randomly selected in the city of Parakou were included. A structured questionnaire collected their self-medication habit, the drugs used, the supply places and the reasons for this practice. Data were analysed using the Epi-data 3.1 software. Results: Of the 335 respondents included in this study, 141 (42.09%) had self-medicated including 130 (38.81%) with anti-malarial drugs. Fever is the main symptom of malaria cited by respondents (129% or 38.51%) followed by headache (93% or 27.76%). The most commonly used anti-malarial drugs for self-medication are quinine (60% or 44.45%) followed by artemisinin-based combination therapy (46% or 34.07%). Eighty-seven respondents (66.92%) did not have a good knowledge of the drug dosage. Reasons for self-medication were mainly the high cost of consultation fees (99% or 54.10%) and good knowledge of one’s illness (53% or 28.96%). Self-medication associated factors were fever (p = 0.04), non-prescription drugs supply in pharmacies (p Conclusion: Self-medication is a common practice in the city of Parakou. Medicines purchased without prescription in pharmacies and drugs availability in street facilitate this practice, which may compromise the effectiveness of anti-malarial drugs.

Awareness and Practice of Proper Health Seeking Behaviour and Determinant of Self-Medication among Physicians and Nurses in a Tertiary Hospital in Southwest Nigeria

Background: There is generally a lack of good health-seeking practices among health professionals due to a variety of factors, including the intensity of the medical practice itself. Doctors and nurses are perceived to have a good knowledge of ideal health-seeking behaviors and as such, it is important to determine the level of their awareness and estimate whether this knowledge is put into practice. This study, therefore, aimed to determine the level of awareness and practices of proper health-seeking behavior and to identify the factors responsible for self-medication among doctors and nurses in a tertiary hospital in Nigeria. Methodology: A cross-sectional descriptive study was conducted between April and may 2018 among 106 doctors and 164 nurses in a tertiary health facility in Ido-Ekiti, Ekiti State, Southwestern Nigeria. A simple random sampling technique by balloting was performed from the list of doctors and nurses in the hospital to select doctors and nurses that participated in the study. A pretested semi-structured self-administered questionnaire was designed and used to collect data. The data were entered into the computer software and analyzed using SPSS version 20. P ≤ 0.05 was taken as significant. Result: Out of 106 doctors and 164 nurses recruited, only 102 doctors and 143 nurses filled the questionnaire completely and returned for analysis. One hundred and four respondents (42.4%) fall within the ages of 31 - 40 years with a male to female ratio of 1:1.23. Awareness of proper health seeking behavior among both doctors and nurses was high among the two groups with no statistically significant difference between them. Twenty-nine (28.0%) doctors compared with thirty-four (23.8%) nurses go for a regular medical check-up with no statistically significant difference between the two groups (p = 0.411). Out of these, 5 (17.2%) doctors and 7 (23.8%) nurses visit at an interval of less than 6 month (p = 0.736). There is a statistically significant difference in the number of doctors (60.8%) compared with nurses (41.3%) that have consulted a doctor in the last one year (p = 0.003). More than half (51.6%) of this consultation among doctors was over the phone whereas 64.4% of such among nurses were via clinic appointment (p = 0.008). More doctors (90.2%) comply with their treatment prescription from physicians compared with nurses (77.6%) (p = 0.010). More nurses compared with doctors self-medicate when ill [Doctor 61.8% (63), Nurses 78.3% (112)] (p = 0.005) and had also self-medicated in the last one year [Doctor 34.3% (35), Nurses 42.7% (61)] (p = 0.187). Decreasing age, decreasing years of experience, increasing working hours, lack of health insurance, fear of confidentiality and lack of satisfaction with health services are factors that significantly increased the likelihood of self-medication among doctors and nurses within the last one year. Conclusion: Awareness of proper health seeking behavior was high but this did not translate into proper health-seeking practices among doctors and nurses. There is apathy for regular medical check-up and self-medication was also high among this group of health workers. Decreasing age and years of experience, increasing working hours, lack of health insurance, fear of confidentiality and lack of satisfaction with health services were factors were identified to significantly increase the likelihood of self-medication.

Self-Medication Practice among Pharmacists in UAE

Objectives: The purpose of this study was to determine the incidence of self-medication behavior among practicing pharmacists in UAE. Methods: This anonymous questionnaire-based study was conducted between October and December 2014, using a prepiloted questionnaire. The questionnaire was distributed to a total of 168 pharmacists. Data were analyzed using SPSS and results were expressed as number of respondents and percentage of total participants. Results: The questionnaire was completed by 149 pharmacists, and response rate was 89% with 53% of respondents being Arabs. Out of the 149 pharmacists respondents, 71 (47.7%) are males, and 78 (52.3%) are females. The mean age among pharmacists was 28. Large number of pharmacists practiced self-medication (96.6%). The majority obtained their medication from pharmacies (92.6%). Most respondents were aware of bacterial resistance and the concept of rational drug use. However, 69 (43%) of pharmacists had used antibiotics without consultation in the past year. The main reasons for self-medication were that their health problem is not serious (42%) and their knowledge on drugs and diseases helps (31%). Reasons against self-medication included risk of misdiagnosis of illness and risk of adverse effects. Pharmacists tended to seek medical consultation mostly in case of symptoms lasting for more than one week or when symptoms were worsening. Discussion: The frequency of self-medication among pharmacists is high. The professional exposure to drugs and knowledge of illness and treatment choice remains the fundamental contributors to self-medication practice among pharmacists. Interventions to promote rational self-medication among practicing pharmacists are required and pharmacists must be encouraged to enter the patient role.

Self-Medication for Oral Health Problems among Dental Outpatients at a Nigerian Tertiary Hospital

Background: Self-medication is the inappropriate use of drugs to treat self-diagnosed disorders or symptoms. Even though Self-medication has benefits as it enhances better use of clinical skills and increases access to medication;it is also associated with risks such as adverse drug reactions and antibiotics resistance. Objectives: To determine prevalence of self-medication practices among dental out-patients, triggering factors that influence self-medication practice and common source of drugs. Materials and methods: This descriptive cross-sectional study was conducted at the Clinic of the Department of Preventive Dentistry, Lagos University Teaching Hospital over a period of 6 months using self-administered questionnaires adapted from previous studies. Data obtained was analysed and expressed as frequencies and percentages. Test of associations was done using chi-square (p Results: Age of respondents ranged from 16 to 78 years (32.24 ± 13.47). M:F was 1:1. Prevalence of self-medication was 45.5%;toothache was the most prevalent reason for self-medication (71%). The frequently used drugs for self-medication were analgesics (65%) while the most common source for the drugs was the pharmacy (60%). Educational status (X2 = 12.85, P 2 = 6.42, P 2 = 10.38, P Conclusion: This study revealed high prevalence of self-medication with toothache as the predominant trigger and pharmacy, the most common source.

Challenges and Possibilities for the Household Medicine Lease （HML） System Viewed in Light of CRM： HML-Based Everyday Self-Medication in Ubiquitous Network Society

Household medicine lease （HML） industry originated way back in the Edo period （17C-19C）, when it was promoted by the local fiefdom government to revitalize the economy. Accumulations of wealth, acquired thereafter from everywhere outside the region, have culminated in the formation of the present-day industrial cluster in Toyama, the largest in the whole area facing the Sea of Japan. Today an adaptation of the quasi-CRM （customer relationship management） business model of the HML system has proved to be a success in Mongolia. This fact seems to offer the authors some clues for dealing with those problems that healthcare and medical services in Japan and elsewhere are riddled with. In this paper, focusing on the common critical success factors （CSFs） behind the success of the authors＇ prototype HML system and its recent successful application in Mongolia, the authors will analyze these factors from the perspective of CRM. The authors will then clarify the following： （1） the usefulness of the business model for ensuring primary healthcare for people in developing countries; （2） the usefulness in our ubiquitous network society of applying ICT to the HML system; （3） possible contributions that the use of the system can make toward improving the quality of our everyday healthcare and medical services in our prominently aging society; and the authors will also suggest （4） the importance of elevating ＂individual self-medication＂ to ＂community-based self-medication＂.

Practice and knowledge of the dangers of self-medication among pregnant mothers attending antenatal care in Iganga District (Uganda)

Background:Self-medication is a common practice among pregnant mothers in many developing countries Uganda inclusive.Despite its adverse effects to the pregnant mother and the developing fetus,limited efforts are in place to reduce the practice.This study was conducted to assess the practices and knowledge of the dangers of self-medication among pregnant mothers attending antenatal care in Iganga district,Uganda.Method s:A cross sectional approach was employed using convenient sampling technique among 181 pregnant mothers at the antenatal clinic.An interviewer administered questionnaire was used to collect data that was analyzed descriptively using SPSS software.Results:Out of the 181 respondents,119(65.75%)self-medicated during their current pregnancy obtaining drugs from pharmacies 42(23.20%).Majority of the mothers 129(71.27%)had good knowledge concerning the dangers of self-medication with 66.85%reporting that it was a bad practice.Regarding the dangers of self-medication,23.76%reported fetal death while 24.86%stated miscarriages.There was a significant association between self-medication practice and occupation(P-value=0.04;OR=1.21 at 95%CI).Conclusion:Self-medication remains a common practice among pregnant mothers in Iganga district despite the fact that a large proportion of them have good knowledge regarding the dangers of self-medication.Therefore,further investigations into the associated factors and strict measures to combat the risks of self-medication during pregnancy should be embarked on.

Prevalence and influence factors of self-medication in Chinese middle-aged and elderly people: evidence from 2011, 2013 and 2015 CHARLS panel data

Self-medication is an increasingly frequent phenomenon worldwide and has an important influence on health.In this study,we analyzed the self-medication prevalence rate in Chinese middle-aged and elderly people,and explored the influence factors.The data from China Health and Retirement Longitudinal Study(CHARLS)in 2011,2013 and 2015 were used.Self-medication prevalence was calculated as the number of whole people divided by the number of people taking self-medication.The influence factors of self-medication were analyzed by panel data random effect model.We excluded observations with missing values in our analysis,leaving 16 962,17 876 and 19 572 observations in 2011,2013 and 2015,respectively.The average 3-year self-medication prevalence was 45.52%.Moreover,11.70%of respondents practiced self-medication with prescription medicine in 2011,2013 and 2015.Respondents living in non-rural areas(P=0.009)and western region(P=0.000)took more self-medication.Self-medication was a common phenomenon among middle-aged and elderly population in China.The government should strengthen the guidance for the middle-aged and elderly people who took more self-medication,such as those living in urban and western region.

Fungal corneal ulcer after repair of an overhanging filtering bleb:A case report

BACKGROUND Overhanging filtering bleb is a common complication after trabeculectomy and surgical repair is an effective treatment when the patient presents with apparent symptoms.Filtering bleb relevant infection including in the filtering bleb itself and even endophthalmitis in some severe cases has been reported.However,corneal fungal infection after filtering bleb repair is rarely reported.CASE SUMMARY A 57-year-old Chinese man who had sensations of redness and foreign body sensations in the left eye 3 wk after repair of overhanging filtering bleb.3 wk ago,due to sensations of a foreign body in the left eye for 3 years with worsening for 3 mo.The patient was diagnosed as overhanging filtering bleb and underwent a repair of overhanging filtering bleb.Postoperative,the filtering bleb formed well and the intraocular pressure is normal.But the patient gradually develop redness,pain and a grey infiltrate of the cornea in the eye.Finally it developed into fungal corneal ulcer.Through asking the medical history,we found the patient had irregularly self-medicated for years with glucocorticoid eye drops for years to relieve the foreign body sensation in the eye caused by filtering bleb overhanging.Because the glucocorticoid eye drops he used years ago had provide normal sensation to the eye.After 3 mo of anti-fungal treatment,the inflammation was controlled.CONCLUSION In addition to avoiding the development of overhanging filtering bleb after trabeculectomy,the present case report also suggests that clinicians should pay more attention to the patient’s ocular self-medication history.Particularly in patients with a history of glaucoma or eye surgery.Because these patients may be exposed to more types of eye drops than other individuals,they may select the wrong medi-cations for long-term use,based on their previous experience.

Corticosteroid-Induced Adrenal Insufficiency in Africa: Report of Nine Cases at the Internal Medicine/Endocrinology-Diabetology Department of Pikine NHC

Introduction: Prolonged corticosteroid therapy is labeled as the main cause of corticotropic adrenal insufficiency. However, the current frequency of this complication remains unknown. The objective of our study was to assess its epidemiologic, diagnostic, therapeutic, and evolutionary aspects of our practice. Methodology: A 60-month retrospective study was performed from May 2014 to April 2020 in the Pikine National Hospital Centre. Data were obtained from the medical records of patients with corticosteroid-induced adrenal insufficiency. Epidemiologic, diagnostic, therapeutic, and evolutionary parameters, and data related to corticotherapy were recorded. Patients with basal plasma cortisol levels <50 ng/ml or a plasma cortisol level less than double of the basal cortisolaemia one H after administration of synachtene 250 were included. Results: Medical records were obtained from nine patients, comprising six women and three men. The mean age of the patients was 48 years. Long-term corticosteroid therapy was used for self-medication in six patients and artificial bleaching in the remaining three patients. Betamethasone was the most commonly used drug in four patients, followed by clobetasol in three patients. Corticotropic insufficiency was revealed as a result of acute decompensation in five patients. All patients presented with a pseudo-cushingoid pattern. Diagnosis of corticotropic adrenal insufficiency was confirmed by measuring basal plasma cortisol levels of <50 ng/ml in seven patients. A standard Synachtene test was performed on two patients. All patients benefited from hydrocortisone supplementation. In the short-term, the outcome was unremarkable for all patients. Medium and long-term progression could be assessed in only three patients. Two patients showed persistent suppression with a 6- and 9-month follow-up. One patient was readmitted after one month due to an adrenal crisis following voluntary discontinuation of hydrocortisone treatment. Conclusion: Post-corticosteroid therapy adrenal insufficiency remains a concern in our practice and is favoured by the non-compliance of providing rules by pharmacies and the parallel drug market.

Evaluation of the Regulation of Antibiotics Consumption in Bujumbura, Burundi

Abstract： Background： Antibiotic self-medication is highly prevalent in the developing countries. The objective of the study was to evaluate self-medication with antibiotics and the regulation of antibiotics consumption in the private and public pharmacies of the urban area of Bujumbura. Methods： A cross sectional study using self-administered questionnaire was conducted in private and public pharmacies of Bujumbura. 460 clients were randomly chosen and 32 sellers randomly selected from January to September 2015 and interviewed. Results： Of the 460 participants, 186 （40.43%） practiced self-medication to antibiotics. The average age was 34.89 years. Abdominal pain was the first motivation to practice self-medication （20.8%）. Amoxicillin was the antibiotic most commonly used （47.3%）. Inaccessibility to health care facilities due to the lack of financial resources was cited to be the root of this phenomenon （62%） and these antibiotics were mostly acquired from community pharmacies without prescriptions （84.4%）. Conclusions： The high cost of care and the low level ofstudy of the patients are factors favoring this phenomenon. A national policy for regulation use of antibiotics without a medical prescription and an educational program to general population on the effective use of antibiotics are therefore needed.

Storage and Management for Medicines in the Home of University Students of the Health Area of Espoch, Ecuador

This work collects the characteristics of the family kits of students from the careers related to health in the Espoch, by identifying their knowledge and habits to determine the relationship between self-medication and the possession of medicines contained in the first-aid kit. This is related to the most outstanding frequency （48.1% bedroom） with the use of medicines in the home （48.5% when the treatment ends）. Taking into account that 63.6% do not have a kit, they stored them in inadequate places to control their stability and quality for the use they were made, being analgesics and antibiotics those commonly found during the inspection that took place in the home. This determines that storage habits are not adequate for the proper storage of medications, including having knowledge of health and the importance of proper use by students, being essential to know that medicines must be stored in fresh places and dry, to avoid damage and problems associated with its stability.